✓ Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD) (1223E0200X) ✓ HHS OIG Screened Clear 🏢 Entity Type 2 (Organization)

ALI ALLEN REZAI DDS APC (NPI #1376455204)

Dentist, Endodontics • PINOLE, CA • Status: Active Federal Registration

⚙️ JSON API
CMS-1500 Box 24J / 33a • NPI
1376455204
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
1223E0200X
Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)
Box 32 Service Location & ZIP+4
1500 TARA HILLS DR STE 206, PINOLE, CA, 94564-2526
✓ 9-Digit EDI 837 ZIP+4 (94564-2526)
Practice Phone & Referral Fax
Direct NPPES Verification Line
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1376455204 (ALI ALLEN REZAI DDS APC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number1376455204 (NPI-2 Organization / Facility)
Provider / Legal NameALI ALLEN REZAI DDS APC
Plain-English SpecialtyLicensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)
NUCC Code: 1223E0200X (Dentist, Endodontics)
Certifying / Licensing BodyAmerican Dental Association (ADA) / State Board of Dental Examiners
Practice Location Address1500 TARA HILLS DR STE 206, PINOLE, CA, 94564-2526
Practice Telephone / FaxTel: (510) 724-4900
Administrative Mailing Address1500 TARA HILLS DR STE 206, PINOLE, CA, 94564-2526
Enumeration & Last SyncEnumerated: 2026-09-17 | CMS Record Updated: 2026-09-17
Authorized OfficialMICHAELA MUNIZ (VP, Payor Relations)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1500 TARA HILLS DR STE 206, PINOLE, CA, 94564-2526

🗺️ Open in Google Maps 🏥 More Providers in PINOLE

Plain-English Taxonomy & CMS Crosswalk (1223E0200X)

What Does Taxonomy Code 1223E0200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1223E0200X translates to:
"Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: American Dental Association (ADA) / State Board of Dental Examiners
Clinical Scope: Routine 6-month dental checkups, toothache, dental abscess, bleeding gums (periodontitis), or wisdom tooth extraction.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ALI ALLEN REZAI DDS APC)

Typical CPT / Diagnostic Procedures:
  • Comprehensive Oral Evaluation, Digital Dental Radiographs & Prophylaxis
  • Restorative Composite Fillings, Crowns, Endodontic Root Canal & Extractions
Common Therapeutic Classes:
  • Amoxicillin, Metronidazole & Clindamycin (Odontogenic Infections)
  • Chlorhexidine Gluconate 0.12% Oral Rinse & High-Fluoride Varnish

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English DescriptionState License & Primary Status
1223E0200X — Dentist, Endodontics
Plain English: Licensed Doctor of Dental Surgery (DDS) / Doctor of Medicine in Dentistry (DMD)
State: N/A | License: Verified | Primary: Yes (Primary)
Medical Billing, RCM & Hospital Credentialing Teams:
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